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BAYSIDE MANOR ASSISTED LIVING LLC
NPI 1316606528
Assisted Living Facility in Gaylord, MN

Active since December 15, 2021CLIA 24D0665028 · Waiver

NPPES record last updated: December 15, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bayside Manor Assisted Living Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BAYSIDE MANOR ASSISTED LIVING LLC (NPI 1316606528) is a healthcare organization registered as an assisted living facility in Gaylord, Minnesota and active in the NPI registry since December 2021. The organization holds a CLIA Waiver certificate valid through May 14, 2027 and lists Joshua Legum, President, as its authorized official.

NPPES Registry Identity

NPI1316606528
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameBAYSIDE MANOR ASSISTED LIVING LLC
Location Address640 3RD STGaylord, MN 55334-2297
Mailing Address2361 Nostrand Ave Ste 903Brooklyn, NY 11210-3953
Phone(507) 237-2911
Organization SubpartNo
Authorized OfficialJoshua LegumPresident · (507) 203-1001
Enumeration DateDecember 15, 2021
NPPES CertifiedDecember 15, 2021
✔ NPI 1316606528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

640 3RD ST, Gaylord, MN 55334
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D0665028

Bayside Manor, LLC · Gaylord, MN
Active · expires May 14, 2027
CLIA Number24D0665028
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateMay 15, 2025
Certificate Expiration DateMay 14, 2027
Laboratory DirectorKelly Murphy
Laboratory Phone(507) 237-2911
Laboratory LocationBayside Manor, LLC640 3rd Street, Gaylord, MN 55334
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GAYLORD LAKEVIEW HOME
Skilled Nursing Facility
640 3RD ST
GAYLORD, MN 55334
Sibley County (507) 237-2911
NICOLE MARIE YOUNG PT
Physical Therapist
640 3RD ST
GAYLORD, MN 55334
Sibley County (507) 237-2911
SARAH ANN SCHWARTZ MA OTR/L
Occupational Therapist
640 3RD ST
GAYLORD, MN 55334
Sibley County (507) 237-2911
RENEE LYNN KLEINDL COTA/L
Occupational Therapy Assistant
640 3RD ST
GAYLORD, MN 55334
Sibley County (507) 237-8730
JACKIE DIETZ
Speech-Language Pathologist
640 3RD ST
GAYLORD, MN 55334
Sibley County (507) 237-8730
JOSH DANIEL GAVIN PTA
Physical Therapy Assistant
640 3RD ST
GAYLORD, MN 55334
Sibley County (507) 237-8730
MRS. ASHLEY MARIA ENGLES M.S. CF-SLP
Speech-Language Pathologist
640 3RD ST
GAYLORD, MN 55334
Sibley County (507) 237-5744
JAIME PETERSEN OTR/L
Occupational Therapist
640 3RD ST
GAYLORD, MN 55334
Sibley County (507) 237-8730

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bayside Manor Assisted Living LLC's NPI number?

The NPI number for Bayside Manor Assisted Living LLC is 1316606528. It was assigned to this organization in the NPPES registry on December 15, 2021.

Where is Bayside Manor Assisted Living LLC located?

Bayside Manor Assisted Living LLC is located at 640 3rd St, Gaylord, MN 55334. The listed phone number is (507) 237-2911.

What is Bayside Manor Assisted Living LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Bayside Manor Assisted Living LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0665028) is associated with this NPI, valid through May 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bayside Manor Assisted Living LLC was last updated on December 15, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.